Breast augmentation is the most popular cosmetic procedure in the US, but there are many reasons why women may choose, or require, to have their implants removed. At Pacific Center Plastic Surgery, our doctors specialize in breast implant revision procedures.
There are several different reasons why women may choose to have their breast implants removed at some point after their augmentation:
The most common reason for re-operation is size change. Many women desire a larger implant after the initial augmentation and healing, when the swelling has diminished, and the final appearance is visualized.
Capsular contracture occurs when the scar tissue surrounding the implant begins to tighten. This can cause feelings of tightness and discomfort and can give the implants a hard look and feel.
A rupture occurs when the outer shell of the implant becomes damaged or tears, allowing the inner content to leak out into the breast pocket. An implant rupture is rare but we recommend removal and replacement. Saline implants will leak and become empty and are readily visible to the patient.
The position of the implants, especially shaped implants, affect the overall appearance of the breasts. Over time, the implants can shift position, causing an asymmetrical and unnatural appearance.
Deformities can develop with breast implants due to scar tissue, visible implant rippling, and weakened breast skin. These can all affect the appearance of the breast shape and contour.
Breast Implant Illness
A small number of patients may experience breast implant illness, a condition that has been linked to silicone breast implants. Breast implant illness may be the body’s response to foreign material, however, the exact cause has not been determined.
Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA ALCL) is another form of breast implant illness requiring removal. Symptoms typically occur 3-14 years after implant placement and may include fluid buildup, pain, swelling, and lumps in and around the breasts.
Breast implant removal can be done in a few different ways. The doctor will make recommendations on the method that best suits your situation.
The removal of the entire breast capsule scar from around the breast implant. It includes the removal of the front and back wall of the implant capsule, therefore meaning the total capsule is removed.
The removal of only part of the breast implant capsule. Typically, the anterior portion of the breast capsule is removed and the back wall is left untouched to minimize the risk of complications.
A breast implant removal technique that involves removing the implant as well as the surrounding scar tissue capsule in one piece, removing all of the scar tissue, implant and gel together, whether the implant has ruptured or is still intact. The technique is also used for permanent removal. En Bloc is frequently used when breast implant illness symptoms have been reported by the patient or when BIA-ALCL has been diagnosed.
Total and partial capsulectomy procedures require a smaller incision compared to that needed with En Bloc removal. This will be discussed in greater detail during the consultation.
With any breast implant removal technique mentioned above, the decision will need to be made whether or not further breast contouring is desired. The options available include:
- Implant removal alone
- Implant removal with a breast lift
- Implant removal with a breast lift and fat grafting (natural augmentation)
- Implant removal with fat grafting only
Depending on the reason for removing the breast implants, it may be recommended to remove the implants for a period of months to let the breasts heal and settle in. At a future date, it can be determined if further enhancement of the breasts is desired.
When Should It Be Considered?
To learn more about specifics on En Bloc, read Board-Certified Dr. Horowitz’s recent two-part series explaining what an En Bloc Explantation is and when is an ideal time to complete the procedure.
To start with part I, click here.
Finding a Surgeon for Breast Implant Removal
Not every plastic surgeon offers breast implant removal with En Bloc. The advanced technique takes years of experience to be successful at completely removing the capsule. Drs Horowitz and Nichter are board-certified with years of experience performing breast augmentation as well as breast implant removal using the total capsulectomy, partial capsulectomy, and En Bloc techniques. To learn more, contact our office and schedule your consultation with Pacific Center Plastic Surgery.